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Open Access Case Report

Mediastinal epithelioid hemangioendothelioma with abundant spindle cells and osteoclast-like giant cells mimicking malignant fibrous histiocytoma

Xiao-Man Li1, Xu-Yong Lin23, Hong-Tao Xu23, Juan-Han Yu23, Liang Wang23, Chui-Feng Fan23, Yang Liu23 and En-Hua Wang23*

Author Affiliations

1 Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang 110001, China

2 Department of Pathology, the First Affiliated Hospital and College of Basic Medical Science, China Medical University, Shenyang 110001, China

3 Institute of pathology and pathophysiology, China Medical University, Shenyang 110001, China

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Diagnostic Pathology 2013, 8:103  doi:10.1186/1746-1596-8-103

Published: 21 June 2013

Abstract

Epithelioid hemangioendothelioma is a relatively uncommon lesion usually presenting in soft tissues. The occurrence in the mediastinum is exceptional rare. Histologically, this tumor is characterized by epithelioid cells with intracytoplasmic vacuoles in a hyalinized or mucinous stroma. Occasionally, spindle cells or osteoclast-like giant cells can be observed. Herein, we present a case of epithelioid hemangioendothelioma in a 38 year-old Chinese male. The tumor was predominantly composed of abundant spindle cells with marked atypia and scattered osteoclast-like giant cells reminiscent of malignant fibrous histiocytoma. The unusual histological appearance can pose a great diagnostic challenge. It may be easily misdiagnosed, especially if the specimen is limited or from fine-needle aspiration.

http://www.diagnosticpathology.diagnomx.eu/vs/5804918529726307 webcite

Keywords:
Epithelioid hemangioendothelioma; Mediastinum; Osteoclast-like giant cells; Malignant fibrous histiocytoma